Mortality among talc miners and millers in New York State

Our plain-English summary of Mortality among talc miners and millers in New York State, by M. Kleinfeld, J. Messite, O. Kooyman, et al (Archives of Environmental Health, 1967).

The study

• Authors: M. Kleinfeld, J. Messite, O. Kooyman, M.H. Zaki
• Journal: Archives of Environmental Health
• Published: 1967;14(5):663-7
• Cited by: 94 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001484).

In plain English

This study followed 220 talc miners and millers in northern New York State. Each had at least 15 years of talc dust exposure by 1940, or reached 15 years between 1940 and 1965. The dust was mainly talc mixed with other silicates such as serpentine and tremolite, plus carbonates and a small amount of free silica. There were 91 deaths. The authors compared the share of deaths from specific cancers with the share among US white men in 1957. Cancers of the lung and pleura made up 10 of the 91 deaths (11%), about four times the expected 3.2%, a statistically significant difference. The excess appeared in workers aged 60 to 79, not in those aged 40 to 59. Cancers of the gastrointestinal tract and peritoneum, including one peritoneal mesothelioma, were not significantly above expected. Twenty-eight deaths were from pneumoconiosis or its complications, 19 of them from cor pulmonale. Among the authors' 152 asbestos insulators, the excess of lung and pleural cancers appeared in both age groups. Without adequate smoking data, the authors stated, the role of smoking could not be assessed.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Mortality follow-up of a group of long-term talc workers (1940 to 1965), using proportional mortality: the share of deaths from specific cancers was compared with the share among US white men in 1957
• Who was studied: 220 talc miners and millers in northern New York State, believed to be the whole work force in this category. They were employed in 1940 with 15 or more years of talc dust exposure, or reached 15 years between 1940 and 1965. There were 91 deaths, and 35 of these had autopsy records.
• Exposure: Talc dust from mining and milling. The dust was mainly talc mixed with other silicates such as serpentine and tremolite, plus carbonates and a small amount of free silica. Among the 80 deceased workers with exposure data, mean exposure was 24.7 years (range 15 to 47). Dust counts were higher before 1945, when wet drilling and other engineering controls were introduced.
• Main results:
  • Among the talc workers, cancer of the lung and pleura caused 10 of 91 deaths (11%), against an expected 3.2%. The authors described this as four times that of the control population, and the difference was statistically significant (P less than 0.01). Of the 10 cases, nine were lung carcinomas and one was a fibrosarcoma of the pleura.
  • By age among the talc workers: in the 60 to 79 age group, lung and pleura cancer was 17% of deaths (8 of 47) against 3.9% expected, which was significant. In the 40 to 59 age group it was 5.3% (2 of 38) against 5.5% expected, which was not significant.
  • Among the talc workers, cancers of the gastrointestinal tract and peritoneum caused 7 of 91 deaths (7.7%), against 5.3% expected. The difference was not statistically significant. One of the seven was a peritoneal mesothelioma.
  • Among the talc workers, 28 of the 91 deaths were due to pneumoconiosis or its complications or both: 19 cor pulmonale, 5 advanced tuberculosis and 4 bronchopneumonia. The time from first talc exposure to these deaths averaged 25.9 years (range 15 to 39). All 28 workers were first exposed before 1945.
  • In the authors' comparison group of 152 asbestos insulators with 15 or more years of exposure, there were 46 deaths (30.3%). In this group, lung and pleura cancer was significantly above expected in both the 40 to 59 and 60 to 79 age groups, and gastrointestinal and peritoneal cancer was significantly above expected overall.
  • Eight of the 10 talc workers with lung or pleural cancer had clear-cut evidence of pneumoconiosis. All 10 were first exposed before wet drilling began. The authors found no evidence of a direct relationship between the length of exposure before wet drilling and lung cancer.
  • Duodenal ulcer was recorded in 29 of the 220 talc workers (13.2%), 10 among those who died and 19 among those still alive. The national figure for males was 2.1%.
  • Average age at death among the 91 talc workers was 60.4 years (range 38 to 84). The authors stated that there did not seem to be a reduction in life span from the exposure.
• The authors' conclusion: The authors concluded that, consistent with earlier studies, cor pulmonale was a major cause of death among these talc miners and millers. They stated that what had not been shown before was the increased incidence of lung cancer in these workers. They suggested that lung or pleural cancers appeared earlier in their asbestos workers partly because of the greater carcinogenicity of asbestos dust, or a higher level of asbestos exposure, or both.
• Limitations the authors state:
  • Adequate smoking data were not available, so the role of smoking in the lung carcinomas could not be assessed in either the talc or the asbestos group. A smoking history was obtained for only 3 of the 10 talc workers with lung or pleural cancer.
  • The national peptic ulcer figure was a point prevalence, while the study's figure was a period prevalence, so the two are not directly comparable.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Talc and vermiculite.

Medical terms in this study, explained in our Lexicon: Talc.

Related studies

• Malignant mesothelioma incidence among talc miners and millers in New York State — M.M. Finkelstein (2012)
• Letter to the editor on commentary: malignant mesothelioma incidence among talc miners and millers in New York state by M M Finkelstein — R.P. Nolan, J.F. Gamble, et al. (2013)
• Pneumoconiosis and malignant mesothelioma in a family operated metal casting business that used industrial talc from New York state — M.M. Finkelstein (2013)
• Mortality of Talc Miners and Millers From Val Chisone, Northern Italy: An Updated Cohort Study — E. Pira, M. Coggiola, et al. (2017)
• An update of a mortality study of talc miners and millers in Italy — M. Coggiola, D. Bosio, et al. (2003)
• Mortality in the cohort of talc miners and millers from Val Chisone, Northern Italy: 74 years of follow-up — C. Ciocan, E. Pira, et al. (2022)

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